II. Definitions
- Jehovah's Witness
- Religious denomination founded in the U.S. in the late 19th century
- As part of religious beliefs, Jehovah's Witnesses generally refuse Blood Transfusions and other blood-based treatments
- Practices vary, and some patients agree to albumin, Clotting Factors and IVIG but refuse cellular products
- Bloodless Medicine
- Practice to reduce the risk of life threatening Anemia in the perioperative period
III. Management: Preoperative Care
- Increase baseline Hemoglobin prior to surgery
- Supplement in the weeks before elective surgery
- Iron Supplementation
- Vitamin B12 Supplementation
- Folic Acid supplementation
- High risk bleeding procedures
- Epoetin Alfa 600 units/kg each week for 4 weeks
- Biosimilar agent Retacrit does not contain Albumin (in contrast to Epogen, Procrit)
- Supplement in the weeks before elective surgery
- Hold medications that increase bleeding risk (if possible)
- See Medications to Avoid Prior to Surgery
- Anticoagulants
- Antiplatelet Agents
- NSAIDs
- Ginkgo Biloba
- Indications for preoperative Desmopressin
IV. Management: Perioperative Care
- Limit blood loss
- Cell Salvage Autotransfusion Devices (e.g. Cell Saver)
- Minimimally Invasive Surgical Procedures
- Avoid Hypothermia (increases risk of Coagulopathy)
- Consider Hemostatic Agents
- Consider Tranexamic Acid
- Have Topical Hemostatic Agents readily available
- Fibrin Sealants (e.g. Tisseel)
- Topical Thrombin (e.g. Recothrom)
V. Management: Postoperative Care
- Limit postoperative blood draws
- Consider pediatric blood tubes
- Consider point of care finger stick levels
- "Bloodless" Agents that increase Hemoglobin
- Parenteral Iron (e.g. Venofer) in Iron Deficiency
- Epoetin Alfa in severe Anemia
- Effects are delayed by at least 4 days
- Other measures for life-threatening Anemia (e.g. Hemoglobin <5 g/dl)
- Hyperbaric Oxygen
- Bovine Hemoglobin-based oxygen carrier (e.g. Hemopure IV)
VI. References
Images: Related links to external sites (from Bing)
Related Studies
| Definition (MSH) | Members of a religious denomination founded in the United States during the late 19th century in which active evangelism is practiced, the imminent approach of the millennium is preached, and war and organized government authority in matters of conscience are strongly opposed (from American Heritage Dictionary of the English Language, 4th ed). Jehovah's Witnesses generally refuse blood transfusions and other blood-based treatments based on religious belief. |
| Concepts | Population Group (T098) |
| MSH | D033221 |
| SnomedCT | 80587008, 137929001 |
| English | Jehovah's Witnesses, Jehovahs Witnesses, Witnesses, Jehovah's, Jehovah's Witness, Jehovah Witness, follower of religion, jehovahs witnesses, jehovah witnesses, jehovah's witnesses, jehovah witness, jehovahs witness, jehovah's witness, Jehovah Witnesses, Jehovah's Witness (person), Watchtower Bible and Tract Society, Jehovah's Witness, follower of religion (person), Jehovah's Witness (follower of religion - person), Jehovah's Witness, follower of religion |
| Swedish | Jehovas vittnen |
| Czech | Svědkové Jehovovi, Svědci Jehovovi |
| Finnish | Jehovan todistajat |
| Russian | SVIDETELI IEGOVY, СВИДЕТЕЛИ ИЕГОВЫ |
| Spanish | Testigo de Jehová (persona), Testigo de Jehová, testigo de Jehová (persona), testigo de Jehová, Testigos de Jehová, persona que profesa la religión, Testigos de Jehová, Testigos de Jehová (religión / filosofía) (persona que profesa una religión) |
| Japanese | エホバの証人派, ものみの塔, エホバの証人 |
| Polish | Świadkowie Jehowy |
| Norwegian | Jehovas vitner |
| French | Témoins de Jéhovah |
| German | Zeugen Jehovas |
| Italian | Testimoni di Geova |
| Dutch | Jehova's Getuige |
| Portuguese | Testemunhas de Jeová |
